Otitis media is a common childhood disease with annual direct costs estimated to exceed $3 billion. Otitis media is the most frequent cause of pediatric practitioner visits and results in more than 20 million antibiotic prescriptions annually. However, the pathogens associated with otitis media have become increasingly resistant to the prescribed antibiotics. Molecular examination of chronic cases of otitis media demonstrates the presence of bacteria encased in complex microbial communities known as biofilms. Antibiotic agents have proven to be ineffective against biofilm infections seen in chronic otitis media. A therapy that is effective against both chronic and acute otitis media, that does not induce microbial resistance, and that is effective against biofilms would be highly beneficial and have significant commercial potential. The goal of this project is to develop a unique, safe, and efficacious treatment for both acute and chronic otitis media. Prototype formulations will be tested in vitro and in an animal model of otitis media. The Specific Aims of the proposal are: Specific Aim 1. Formulate Iocide for use in treating otitis media Specific Aim 2. Evaluate Iocide for antibacterial activity on planktonic and biofilm bacteria in vitro Specific Aim 3. Demonstrate the effectiveness and safety of Iocide in an animal model of otitis media. PUBLIC HEALTH RELEVANCE: Otitis media is a common childhood disease with annual direct costs estimated to exceed $3 billion. Otitis media is the most frequent cause of pediatric practitioner visits and results in more than 20 million antibiotic prescriptions annually. Consequent to the widespread use of antibiotics, the pathogens associated otitis media have become increasingly resistant to antibiotic therapy. [unreadable] [unreadable] [unreadable]